Conceiving After The Pill
Question
I have a question that so far I haven’t been able to find an answer to. I quit taking the Pill 10 months ago and at that time started NFP. After three months off the Pill my husband and I started trying to conceive. I have used NFP every month for the last 10 months, but have had no luck conceiving. About 3-4 days before the end of my cycle (which has always been 28-30 days ) I start to have brown mucus or spotting. I then know that I am probably not pregnant, and then on day 28-30 I start my period. I’m not sure what this means, could it be a side effect from taking the pill? I would be thankful for any help you could give me.
Answer
Last Updated: June 9, 2013
You do not state your age, the duration of time on the pill, the length of your cycles, or the type of NFP you are using. Various aspects of hormone production can be inferred from NFP charting including peak mucus production, timing and quality of ovulation, and estrogen and progesterone output. End of cycle spotting often occurs from deficient progesterone. A defect in progesterone production can either be gross or subtle. Progesterone deficiencies can cause either infertility or miscarriage.
I would encourage you, first of all, to have a good gynecological exam to make sure that you do not have spotting from cervical inflammation, polyps, or other causes that might require an ultrasound or biopsy to detect. If you do not have this type of problem, the cause is likely to be deficient progesterone.
Some subtle defects in progesterone (termed luteal phase defect) can only be detected if one can deduce the time of ovulation from NFP charting, ultrasound, or LH monitoring, combined with multiple measurements of progesterone in the post-peak or luteal part of the cycle after ovulation has persumably occurred. Diagnosing a luteal defect can be complex, and many physicians are unaware of how to do it. We even have multiple articles in the ob/gyn literature stating that luteal phase defect does not exist, written by physicians who do understand how to do it! Luteal phase defects can be treated with progesterone in the luteal phase in the cycle, HCG injections, or at times Clomid. The key is careful diagnosis, and careful monitoring of postreatment hormones and cycle characteristics.
Dr. Mary Davenport
I would encourage you, first of all, to have a good gynecological exam to make sure that you do not have spotting from cervical inflammation, polyps, or other causes that might require an ultrasound or biopsy to detect. If you do not have this type of problem, the cause is likely to be deficient progesterone.
Some subtle defects in progesterone (termed luteal phase defect) can only be detected if one can deduce the time of ovulation from NFP charting, ultrasound, or LH monitoring, combined with multiple measurements of progesterone in the post-peak or luteal part of the cycle after ovulation has persumably occurred. Diagnosing a luteal defect can be complex, and many physicians are unaware of how to do it. We even have multiple articles in the ob/gyn literature stating that luteal phase defect does not exist, written by physicians who do understand how to do it! Luteal phase defects can be treated with progesterone in the luteal phase in the cycle, HCG injections, or at times Clomid. The key is careful diagnosis, and careful monitoring of postreatment hormones and cycle characteristics.
Dr. Mary Davenport
Answered By:
Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.
